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Orthodontic Emergencies

Having an issue with your braces or aligners? Most orthodontic problems are minor and can be resolved at home. Here’s what to do for common issues—and when to call us.

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Need Immediate Help?

Call us at (617) 484-3260

During office hours: We’ll help you right away
After hours: Leave a message and we’ll call you back ASAP

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Most issues can wait until our next available appointment

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Many problems have simple at-home solutions

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True emergencies are rare—don’t panic!

Common Issues & How to Fix Them

Here are the most common orthodontic issues and step-by-step solutions you can try at home.

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Poking or Protruding Wire

MOST COMMON ISSUE • Usually not urgent

As your teeth move, the wire can slide through the bracket and stick out the back, poking your cheek or gums.

At-Home Solutions:

1

Cover with Wax

Place orthodontic wax over the poking wire to create a smooth barrier. This provides immediate relief.

2

Call Us Immediately

We'll determine if you should move to the next aligner, wear your previous one longer, or if we need to order a replacement.

3

Clip the Wire (Last Resort)

If nothing else works, you can carefully clip the wire with clean nail clippers. Clip as close to the bracket as possible, then cover with wax.

When to call: If you can’t fix it or it’s causing significant pain

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Loose or Broken Bracket

COMMON • Not urgent but needs attention

A bracket may come loose from your tooth. This usually happens from eating hard/sticky foods or accidentally bumping your mouth.

What to Do:

If Bracket is Still on Wire

Leave it in place! The bracket can usually stay on the wire until your next appointment. Cover with wax if it's irritating.

If Bracket Came Off Wire

Carefully remove it and bring it with you to your next appointment. Don't throw it away!

Don't Try to Reattach

Never try to glue or reattach a bracket yourself. We'll reattach it properly at the office.

When to call: Schedule a repair appointment within 1-2 weeks. If multiple brackets break, call sooner.

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Wire Came Out of Bracket/Tube

UNCOMMON • May need appointment

The wire can slip out of the bracket or back tube, especially if a bracket breaks.

What to Do:

Try to Reinsert

Using clean tweezers or needle-nose pliers, gently try to slide the wire back into the bracket or tube. Use a mirror for better visibility.

If You Can't Reinsert

Cover the end with wax to prevent poking, and call us to schedule a repair.

When to call: Contact us within a few days to schedule a repair

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Lost Rubber Band/Elastic

VERY COMMON • Easy fix

Elastics can break or come off during eating or sleeping.

What to Do:

Replace Immediately

Put in a new elastic right away. Always carry extras with you! If you run out of elastics, call us and we'll get you more..

When to call: Only if you’ve run out of elastics and need more

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Sore Teeth After Adjustment

COMPLETELY NORMAL • Not an emergency

Teeth typically feel tender for 2-3 days after adjustments. This is a good sign—it means your teeth are moving!

Relief Methods:

Eat soft foods for a day or two (soup, yogurt, mashed potatoes)
Take over-the-counter pain reliever (ibuprofen or acetaminophen)
Rinse with warm salt water
Apply orthodontic wax to any areas rubbing your cheeks

When to call: If pain lasts more than 5 days or is severe

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Irritated Cheeks, Lips, or Tongue

COMMON INITIALLY • Temporary

Your mouth needs time to adjust to braces. The inside of your cheeks and lips will "toughen up" within a few weeks.

Healing Tips:

Use orthodontic wax on brackets causing irritation
Rinse with warm salt water (1 tsp salt in 8 oz warm water) several times daily
Apply oral gel like Orajel to sore spots
Avoid acidic or spicy foods that can aggravate sores

When to call: If sores don’t heal within 7-10 days or seem infected

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Lost or Broken Invisalign Aligner

FOR INVISALIGN PATIENTS • Needs quick action

If you lose or break an aligner, don't panic! We have options to keep your treatment on track.

What to Do:

1

Try to Reinsert

Using clean tweezers or needle-nose pliers, gently try to slide the wire back into the bracket or tube. Use a mirror for better visibility.

2

Call Us Immediately

We'll determine if you should move to the next aligner, wear your previous one longer, or if we need to order a replacement.

3

Don't Skip Wearing Aligners

Never go days without wearing an aligner—your teeth can shift back quickly!

When to call: Immediately—same day if possible

True Orthodontic Emergencies

These situations require immediate attention. Call us right away or visit an emergency room.

Trauma to Face or Mouth

If you experience a blow to the face that causes severe pain, bleeding, knocked-out teeth, or broken jaw, seek immediate medical attention at an emergency room. Then call us once you've been evaluated.

Action: Emergency room first, then call our office

Severe Infection or Swelling

If you have severe swelling of the face, gums, or neck, or signs of infection (fever, pus, extreme pain), this is a medical emergency that needs immediate attention.

Action: Call us immediately or go to emergency room

Swallowed or Inhaled Orthodontic Part

If you swallow a bracket or wire, it will usually pass without issue. However, if you have trouble breathing, chest pain, or think you inhaled something, go to the emergency room immediately.

Action: If breathing difficulty, go to ER. If swallowed, call us and monitor

Severe, Unmanageable Pain

While some discomfort is normal, severe pain that doesn't respond to pain relievers or prevents eating/sleeping is not normal and should be addressed immediately.

Action: Call our office immediately for guidance